<div class="layuimini-container">
    <form id="app-form" class="layui-form layuimini-form">
        
        <div class="layui-form-item">
            <label class="layui-form-label">名称</label>
            <div class="layui-input-block" disabled="disabled">
                <input type="text" name="name" class="layui-input" disabled placeholder="请输入名称" value="{$row.name|default=''}">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">联系方式</label>
            <div class="layui-input-block" disabled="disabled">
                <input type="text" name="phone" class="layui-input" disabled placeholder="请输入联系方式" value="{$row.phone|default=''}">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">驳回原因</label>
            <div class="layui-input-block" disabled="disabled">
                <input type="text" name="examine_content" class="layui-input" disabled placeholder="暂无驳回原因" value="{$row.examine_content|default=''}">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label required">门店图片</label>
            <div class="layui-input-block layuimini-upload">
                <input autocomplete="off" name="store_images" lay-verify="required" class="layui-input layui-col-xs3"   placeholder="请上传门店图片" value="{$row.store_images|default=''}">
                <div class="layuimini-upload-btn">
                    <span><a class="layui-btn"  data-upload="store_images" data-upload-number="many" data-upload-exts="png|jpg|ico|jpeg" data-upload-icon="image"><i class="fa fa-upload"></i> 上传</a></span>
                </div>
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label required">营业执照</label>
            <div class="layui-input-block layuimini-upload">
                <input autocomplete="off" name="business_license_images" lay-verify="required" class="layui-input layui-col-xs3"   placeholder="请上传营业执照" value="{$row.business_license_images|default=''}">
                <div class="layuimini-upload-btn">
                    <span><a class="layui-btn"  data-upload="business_license_images" data-upload-number="many" data-upload-exts="png|jpg|ico|jpeg" data-upload-icon="image"><i class="fa fa-upload"></i> 上传</a></span>
                </div>
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label required">身份证头像面</label>
            <div class="layui-input-block layuimini-upload">
                <input autocomplete="off" name="identity_card_just_images" lay-verify="required" class="layui-input layui-col-xs3"   placeholder="请上传身份证头像面" value="{$row.identity_card_just_images|default=''}">
                <div class="layuimini-upload-btn">
                    <span><a class="layui-btn"  data-upload="identity_card_just_images" data-upload-number="many" data-upload-exts="png|jpg|ico|jpeg" data-upload-icon="image"><i class="fa fa-upload"></i> 上传</a></span>
                </div>
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label required">身份证国徽面</label>
            <div class="layui-input-block layuimini-upload">
                <input autocomplete="off" name="identity_card_back_images" lay-verify="required" class="layui-input layui-col-xs3"   placeholder="请上传身份证国徽面" value="{$row.identity_card_back_images|default=''}">
                <div class="layuimini-upload-btn">
                    <span><a class="layui-btn"  data-upload="identity_card_back_images" data-upload-number="many" data-upload-exts="png|jpg|ico|jpeg" data-upload-icon="image"><i class="fa fa-upload"></i> 上传</a></span>
                </div>
            </div>
        </div>
        <div class="hr-line"></div>
        <div class="layui-form-item text-center">
            <button type="submit" class="layui-btn layui-btn-normal layui-btn-sm" lay-submit>确认</button>
            <button type="reset" class="layui-btn layui-btn-primary layui-btn-sm">重置</button>
        </div>

    </form>
</div>